Sunday, January 24, 2021

Congress lets kids’ health insurance program expire


Congress failed to renew funding for the federal Children’s Health Insurance Program, or CHIP, by the expiration on Sunday, October 1, but most people aren’t terribly worried, because funding will inevitably be renewed at the federal level, the Deseret News reports from Utah.

A spokesman for Sen Orrin Hatch of Utah, who is now the chairman of the Finance Committee and one of CHIP’s original creators, said in an email that states “have funding to continue the program and will not run out before the new legislation passes”: “No families will be in turmoil. … The bill will pass in time for funding to continue uninterrupted, and we have been in touch with state leaders throughout the process,” the paper quoted him as saying.

Indeed, a version of reauthorization developed by Mr Hatch, a Republican, and Sen Ron Wyden, Democrat of Oregon, passed the Senate’s Finance Committee Wednesday. But it has a ways to go, and each chamber will take separate recesses over the next two weeks.

Under their bill, the renewal would continue CHIP funding from the federal government through 2022. It’s a compromise of sorts: Republicans wanted a reauthorization every two years, while Democrats gave in on Republicans’ demands that extra subsidies be terminated—they come from the hated Obamacare. Those will be phased out over five years instead of ending abruptly.

Before CHIP, about 14 percent of children in the US were uninsured, according to figures from the federal government. As of 2015, that percentage had dropped to 4.5 percent. So some activists have expressed concern, including Carol Burris, who serves as the executive director for the Network for Public Education.

“Since 1997, [CHIP] has provided low-cost health insurance for nine million American children whose families have financial need,” she wrote in an email message. “CHIP also provides coverage for pregnant women. CHIP was due to be reauthorized by September 30. But Congress just let it expire. That means that funding will run out soon, putting the health of millions of children at risk. Administrative and fiscal problems will continue to mount for the states that depend on federal funding for their CHIP programs.”

So there’s a little bit of alarm among activists, given that funding in most states will expire by the end of next year if it’s not renewed, with some states needing federal money much sooner to keep coverage uninterrupted. By March 2018, CHIP funds will be exhausted in 30 states, including Alabama, California, Colorado, Connecticut, Florida, Massachusetts, New York, Ohio, Oregon, and Pennsylvania. Another 19 states are expected to use up their money from April to June 2018, with one state exhausting its funds from July to September 2018.

In Alabama, the program is called ALL Kids and provides funding for children in families that earn too much to qualify for Medicaid but still struggle to afford coverage. It’s administered through the Alabama Department of Public Health, but for the past two years, 100 percent of the funding for ALL Kids has come from the federal government, the Birmingham News reported.

The program covers routine care, including check-ups and vaccinations, as well as prescriptions and hospital care. Services are provided at low or no cost for families with incomes less than twice the poverty level, or about $40,000 a year for a family of three.

(The implementation of the program in Maryland is a little different. Under federal Medicaid “maintenance of effort” rules, kids can’t be kicked out unless the federal government approves such an action. But if that doesn’t happen and federal funding isn’t renewed, the state would have to pay a portion of the 88 percent of the program that now comes from the feds. Covering the estimated 140,000 kids in the state who benefit from CHIP could be expensive.)

Despite widespread and bipartisan support for CHIP, which rose from the ashes of President Bill Clinton’s failed national healthcare initiative, Congress is simply distracted at the moment, especially with its own failed attempts to repeal and replace Obamacare.

A version of the bill now in the House would help offset the $118.5 billion cost over five years of the program by making senior citizens who earn more than half a million dollars annually pay higher Medicare premiums than other senior citizens pay. The reconciliation between the two versions of the reauthorization should be pretty quick, provided Congress acts.

But in the meantime, some states are scrambling to find funding. Federal officials on Monday approved a $3.6 million emergency infusion for Minnesota after the state’s human services chief warned that pregnant women and some children were at imminent risk of losing health care coverage under CHIP, the New York Times reported.

“We know that there is a desire in Congress to provide the funds, but we have heard that same sentiment all through the spring and the summer,” the paper quoted Nathan Checketts, the deputy director of the Utah Health Department, as saying. “Congress needs to get this done as soon as possible, so states do not have to begin notifying people that their coverage may end.”

It’ll happen, eventually, because the program enjoys strong support from all sides of our political aisles. Some states might start notifying people as early as next month that their health insurance coverage could run out if reauthorization doesn’t get all the way through Congress before then. But the urgency in Washington is apparent on this one.

“If making sure that every child in America has access to health care, if that is not a priority, what is?” the Times quoted Rep Jan Schakowsky, Democrat of Illinois, as asking. “Families are waiting anxiously while their health security is hanging in the balance.”

Paul Katula
Paul Katula is the executive editor of the Voxitatis Research Foundation, which publishes this blog. For more information, see the About page.

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